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Table 2 Critically informed analysis

From: Raising the curtain on the equality theatre”: a study of recruitment to first healthcare job post-qualification in the UK National Health Service

Questions derived from the Healthcare Workforce Equity + Diversity Lens Emerging issues for healthcare workforce recruitment Illustrative quotes from recruiting managers in nursing (NRM) and physiotherapy (PRM)
1) Do recruiting managers express clear goals and policies, targets, or performance indicators for workforce diversity? (Are these personal, unit, organisational, or other?) •Recruiting managers are aware of their trust’s recruitment and selection policies which emphasise equality for candidates “we’re wanting diversity, you want people to represent the communities in which they serve.” [Int 2: NRM band 7 White M]
  • Recruiting managers suggested that workforce diversity is desirable but not essential "[the local] population is BME [black and minority ethnic] and its very diverse […] It mirrors their background, mirrors what they see normally, and you know, it's easy to serve the population that you mirror.” [Int 12: NRM band 8 Black F]
  • Although recruiting managers feel it is important for the workforce to reflect the diversity of populations served, they do not have specific goals or targets for workforce diversity for their unit or organisation
2) Are recruiting managers involved in, or aware of, any workforce engagement and monitoring of diversity, or actions to identify or address diversity issues? • Some recruiting managers were cautious about talking about the ethnicity of candidates and how to broach the subject of ethnic diversity in recruitment, indeed they felt talking about ethnicity went against the principles of equality “Oh God no, not at all….No, not at all. It doesn’t factor at all, to be honest with you, we’re all from somewhere else, do you know what I mean, I’m Irish… so no. " [Int 4: NRM band 8 White F]
  • Recruiting managers were unlikely to talk about race equality or to openly discuss ethnicity issues in relation to recruitment “In my years of doing interviewing appointment that I could honestly say that I’ve [n]ever experienced that there is any discrimination at any point in the interview process.” [Int 5: PRM band 8 White F]
  • Some recruiting managers were fearful that they might be accused of being racist if attention was directed towards the ethnicity of the candidates they have appointed "I've got to be so careful what I say, when I came here the majority of my staff were black and probably Filipino, that has changed completely and I feel very conscious of that and I actually feel a little fearful and I'm surprised no one has pulled the racist card and I have a very black but also older workforce, but they don’t want to further themselves […] I've recruited 50 new members of staff in the last 12 months and lots of them have been young, white dynamic nurses.” [Int 11: NRM band 8 White F]
3) Are recruiting managers aware of, or engaged in, any monitoring or assessment of ethnic diversity in recruitment? • Recruiting managers were unaware of ethnic inequalities in job appointments in their trust and when they were made aware of the statistics, they wrongly attributed discrepancies to a perceived weakness in ethnically diverse candidates “I think those candidates who find it difficult, in all honesty, would have to look at themselves to say is there, issues within themselves?” [Int 2: NRM band 7 White M]
   “In all honesty I don’t know whether it was a bad year they [referring to ethnically diverse candidates] qualified and there was so many people looking for jobs, maybe they left it too late, maybe they failed their drug test”. [Int4: NRM band8 White F]
   “It’s about the individual, I think if you prepare yourself, you come in, you give us what we want, there’s no way, because to turn somebody down you have to be 100%, you know, I can’t say ‘just because the way you look’ I’m not going to offer you a job’ [Int 9: NRM band 8 Asian M]
  • Recruiting managers were not responsible for monitoring or feeding back about ethnicity in recruitment and some wrongly conflated issues of racial inequalities with a perceived deficit in the training of overseas nurses “I know, there are issues with some overseas training courses and whether they're [British graduates from ethnically diverse backgrounds] potentially getting lumped in with that and actually whether there's been a judgement made that actually they're not coming from an English [university].” [Int 8: PRM band 8 White M]
  • All recruiting managers were able to make informal assessments and judgements about the ethnic diversity of their unit staff and the candidates they have appointed, they were less likely to be able to make a judgement about the ethnicity of applicants to posts or to identify underrepresentation in applicants to jobs
4) How far do recruiting managers value candidates as unique individuals that have different skills and abilities, assets, potential and strengths, to serve diverse patient groups and populations? • Recruiting managers said that they valued candidates as individuals but there was no time or resources to offer support to new recruits “It’s just not a luxury we have […] we need somebody to come in and just get on with the job, not have lots and lots of supervision, training, and things.” [Int 8: NRM band 8 White M]
  • For all recruiting managers, a policy of equality in recruitment meant adhering to job selection criteria for shortlisting and using and using candidate scoring systems based on technical competencies  
  • Recruiting managers were often responsible recruiting large numbers of staff in a short period of time alongside having clinical management duties, which could result in pressure to appoint “Some of them stand out, you know, they’ve done additional pieces of work, or they’ve travelled, or they’ve done, you know, and they’ve got keen interest in different things” [Int 12: NRM band 8 Black F]
  • Selection processes including technical exercises, group interviews, visits to the unit and individual interviews were used to assess candidates and make judgements about suitability for the job "… have they been to Cambodia voluntarily, you know, working in an orphanage or something like that? Have they been to Africa? Or have they helped out in the London Marathon? Have they done something additional outside, maybe voluntarily?” [Int 3: PRM band 8 White M]
  • Because of a pressurised competitive system, recruiting managers said they felt they made judgements about which candidates demonstrated experiences or skills above and beyond specified job criteria “appearance is another thing you take into consideration, if somebody comes in scruffy, low top, short dress, we do mark them down” [Int1: NRM band 7 Black F]
“they just walk in with a t-shirt on, just you know, it looks a bit scruffy” [Int6: NRM band 7 Black F]
  • Recruiting managers said they judged candidates on their presentation at interview including their appearance and professionalism, some suggested that candidates from ethnic minority backgrounds should be made aware that they were being judged by their appearance as a professional “I think it would help in, you know, to give that sort of guidance to them, you know, professional trends, you know, how they face so that students are aware when this is what you will be expected, some sort of preparation.” [Int 7: NRM band 8 Asian F]
5) How are the interests or concerns of underrepresented ethnically diverse groups heard, voiced, or advocated for in relation to recruitment practices? • Some recruiting managers were sceptical about equity in recruitment as they perceived it as undermining equality, or showing favouritism or positive discrimination “I don’t agree with positive discrimination, I think I treat everyone equally.” [Int 11: NRM band 8 White F]
  • Some recruiting managers said they openly try to encourage ethnically diverse candidates to apply to posts, by including statements about diversity in job advertisements "I’m thinking, okay, that’s obviously not an English name, although I’m sort of judging them on the name but it might be they’re married and I try thinking, okay, is there anything on this paper that can actually get me to get this person to come and be shortlisted” [Int 1: NRM band 7 Black F]
  • Some recruiting managers said they informally encourage ethnically diverse candidates to apply by informing individuals known to them about upcoming posts and how to apply “I would try my utmost first to get that person and obviously if they don’t come up to scratch then I won’t shortlist them… I'd will them to do well, I'm always willing them to do well." [Int1: NRM band 7 Black F]
[candidates from a named university] “they’re basically guaranteed an interview.” [Int 2: NRM band 7 White M]
  • None of the recruiting managers reported equity interventions or initiatives designed to encourage underrepresented ethnically diverse groups to apply, or to address barriers to recruitment or selection, indeed candidates were more likely to be offered an interview based on the university they were attending rather than their grade or experience
6. How far do recruiting managers see a need for change, better understanding, relationships, or resilience building between groups or organisations to support fairer recruitment and retention of human potential? • Although some recruiting managers sense ethnically diverse candidates may have to work harder to be the strongest candidate on the day, not everyone perceives ethnic inequality in first job success to be wrong or problematic for their trust “I honestly don’t know, it’s not something I’ve ever thought about [ethnic inequalities in job success] or come across.” [Int 8: NRM band 8 White M]
  • Some recruiting managers are perplexed and want more information and statistics to better understand ethnic inequalities in first job success “Anecdotally yes, yes, it doesn't surprise me, I can't tell you why … there were girls from BME groups, and they were pretty good … we had exceptional talent … in terms of the, of saying why others don't get the job, I have no idea, no, no because the ones I've seen were really good.” [Int 12: NRM band 8 Black F]
“It’d be interesting to know what the actual ethnic minority and whether that has an impact on whether they’re then selected or not as I say, because that’s not something that we’re aware of” [Int10: NRM band 8 White F]
  • One recruiting manager (from an ethnically diverse background) suggested that candidates needed to realise they would need to show they were better prepared and better able for the post than their white counterparts “Obviously having come up from that pool of candidates myself I’ve always been aware that I will have to present myself as more able, I don’t know how to sort of put it correctly, maybe there is no correct way, I know potentially I will have to be a stronger candidate […] I think that still stands in some regard. [Int 6: NRM band 7 Black F]
  • One recruiting manager (from an ethnically diverse background) spoke about racial bias in recruitment "We’re supposed to be, or we are a progressively more integrated society, there’s no two ways about that one, but some things intrinsically are there, way back sometimes beyond what people actually are consciously thinking, and sometimes that affects their decision making” [Int 6: NRM Black F]